STRUCTURAL EQUATION MODELLING TO EXAMINE THE AFFECTED FACTORS OF KINESIOPHOBIA IN POSTMENOPAUSAL WOMEN WITH CHRONIC LOW BACK PAIN
Yıl: 2021 Cilt: 32 Sayı: 3 Sayfa Aralığı: 22 - 32 Metin Dili: İngilizce DOI: 10.21653/tjpr.797833 İndeks Tarihi: 27-10-2022
STRUCTURAL EQUATION MODELLING TO EXAMINE THE AFFECTED FACTORS OF KINESIOPHOBIA IN POSTMENOPAUSAL WOMEN WITH CHRONIC LOW BACK PAIN
Öz: Purpose: The pragmatic aim of this study was to show affected factors including pain, disability level, and anxiety of kinesiophobia using structural equation modeling (SEM) in postmenopausal women with chronic low back pain (CLBP). Methods: The study was conducted with 200 women aged 45–75 years. Tampa Scale for Kinesiophobia 11, Hospital Anxiety and Depression Scale, Roland Morris Disability Questionnaire, and Visual Analog Scale were used. The SEM was also used to analyze the direction and power of complex interactions between kinesiophobia and anxiety, pain intensity, and disability level by using hypothetically designed models. The average pain intensity was 5.98 (2.39). Results: The average age of the women was 58.00±8.39 years. The average menopausal age was 45.75±5.95. The average kinesiophobia point was 25.97±8.57. Anxiety risk score was 14.74±11.27; depression risk score was 12.39±10.51. The SEM analysis outcome showed that the final model was expository kinesiophobia with pain, anxiety, and disability level (chi-square=21.37; df=28; p=0.810). Anxiety was found as a strong mediator in the relationship between kinesiophobia and pain intensity and disability. Conclusion: This study showed that SEM was appropriate method to explain relationships between kinesiophobia and pain, anxiety, and disability. The created model also showed that anxiety was a strong mediator in postmenopausal women with CLBP.
Anahtar Kelime: POSTMENAPOZAL DÖNEMDEKİ KRONİK BEL AĞRILI KADINLARDA KİNEZYOFOBİYİ ETKİLEYEN FAKTÖRLERİN YAPISAL EŞİTLİK MODELİ İLE İNCELENMESİ
Öz: Amaç: Bu çalışmanın amacı, postmenopozal dönemdeki kronik bel ağrılı (KBA) kadınlarda ağrı, özür, kinezyofobi ve anksiyete düzeyini etkileyen faktörleri yapısal eşitlik modeli (YEM) ile incelemekti. Yöntem: Çalışma 200 kadınla gerçekleştirildi. Tampa Kinezyofobi Ölçeği Kısa formu 11, Hastane Anksiyete ve Depresyon Ölçeği, Roland Morris Engellilik Anketi ve Vizüel Analog Skalası kullanıldı. YEM hipotetik olarak modeller tasarlanarak kinezyofobi ile anksiyete, ağrı şiddeti ve özür düzeyi arasındaki karmaşık etkileşimlerin yönünü ve gücünü analiz etmek için kullanıldı. Ağrı şiddeti ortalamaları 5,98±2,39 idi. Sonuçlar: Kadınların yaş ortalaması 58,00±8,39 yıldı. Katılımcıların menapoza girdikleri yaş ortalaması 45,75±5,95 idi. Kinezyofobi puan ortalaması 25,97±8,57. Anksiyete risk ortalaması 14,74±11,27; depresyon risk ortalaması 12,39±10,51 idi. Yapısal eşitlik analizi sonucunda oluşturulan son model; ağrı şiddeti, anksiyete ve özürlülük düzeyiyle kinezyofobi etkileşimini açıklamada yeterli bulundu (ki-kare=21,37; df=28; p=0,810). Anksiyete; kinezyofobi, ağrı şiddeti ve özürlülük arasındaki ilişkide güçlü bir mediatör olarak bulundu. Tartışma: Çalışma, YEM’in kinezyofobi ile ağrı şiddeti, anksiyete ve özür arasındaki ilişkileri açıklamak için uygun bir yöntem olduğunu gösterdi. Bu çalışmada oluşturulan model, anksiyetenin postmenopozal dönemdeki kronik bel ağrılı kadınlarda güçlü bir mediatör olduğunu ortaya koydu.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- 1. E Silva AVS, Lacativa PGS, Russo LAT, Gregorio LH, Pinheiro RAC et al. Association of back pain with hypovitaminosis D in post- menopausal women with low bone mass. BMC Musculoskelet Disord. 2013;14:184. https://doi.org/10.1186/1471-2474-14- 184.
- 2. Uluğ N, Yakut Y, Alemdaroğlu İ, Yılmaz Ö. Comparison of pain, kinesiophobia and quality of life in patients with low back and neck pain. J Phys Ther Sci. 2016;28:665-670. https://doi. org/10.1589/jpts.28.665.
- 3. Hapidou EG, O’Brien MA, Pierrynowski MR, Las Heras E, Patla T. Fear and avoidance of movement in people with chronic pain: psychometric properties of the 11-Item Tampa Scale for Kine- siophobia (TSK-11). Physiother Can. 2012;64:235-241. https:// doi.org/10.3138/ptc.2011-10.
- 4. Flores-Ramos M, Silvestri Tomassoni R, Guerrero-López JB, Sa- linas M. Evaluation of trait and state anxiety levels in a group of peri-and postmenopausal women. Women Health. 2018;58:305- 319. https://doi.org/10.1080/03630242.2017.1296059.
- 5. Wáng YXJ, Wáng JQ, Káplár Z. Increased low back pain preva- lence in females than in males after menopause age: evidences based on synthetic literature review. Quant Imaging Med Surg. 2016;6:199-206. https://doi.org/10.21037/qims.2016.04.06.
- 6. Hoyle RH, Editor. Handbook of structural equation modeling. New york: A Division of Guilford Publications. c2012.
- 7. Wolf EJ, Harrington KM, Clark, SL, Miller MW. Sample Size Require- ments for Structural Equation Models: An Evaluation of Power, Bias, and Solution Propriety. Educ Psychol Meas. 2013;76:913– 934. https://doi.org/10.1177/0013164413495237.
- 8. Erden A, Altuğ F, Malkoç A, Akgül Kocabal A. Investigation Of The Relationship Between Kinesiophobia, Pain, Anxiety-Depression Status And Quality Of Life In Patients With Knee Osteoarthritis Before Surgery. OTSHD. 2016;7:1-17. https://doi.org/10.17372/ OTSHD.2016.7.16650.
- 9. Yilmaz ÖT, Yakut Y, Uygur F, Uluğ N. Turkish version of the Tam- pa Scale for Kinesiophobia and its test-retest reliability. Turk J Physiother Rehabil. 2011;22:44-49.
- 10. Aydemir Ö, Guvenir T, Kuey L, Kultur S. Validity and reliability of Turkish version of hospital anxiety and depression scale. Turk Physciatry Derg. 1997;8:280-287.
- 11. Küçükdeveci AA, Tennant A, Elhan AH, Niyazoğlı H. Validation of the Turkish version of the Roland-Morris Disability Question- naire for use in low back pain. Spine. 2001;26:2738-43. https:// doi.org/10.1097/00007632-200112150-00024.
- 12. Hooper D, Coughlan J, Mullen M. Structural equation modelling: Guidelines for determining model fit. EJBRM. 2008;6:53-60.
- 13. Trocoli TO, Botelho RV. Prevalence of anxiety, depression and ki- nesiophobia in patients with low back pain and their association with the symptoms of low back spinal pain. Rev Bras Reumatol Engl Ed. 2016;56,330–336. doi:10.1016/j.rbre.2016.02.010.
- 14. Bilgin S, Cetin H, Karakaya J, Kose N. Multivariate Analy- sis of Risk Factors Predisposing to Kinesiophobia in Per- sons With Chronic Low Back and Neck Pain. J Manipulative Physiol Ther. 2019;42(8):565-571. https://doi.org/10.1016/j. jmpt.2019.02.009.
- 15. Branström H, Fahlström M. Kinesiophobia in patients with chronic musculoskeletal pain: differences between men and women. J Rehabil Med. 2008;40:375-380. https://doi. org/10.2340/16501977-0186.
- 16. Durmaz T. Investigation of the factors effect on low back pain in postmenopausal women. 15th World Congress on Meno- pause. 28 September-01 October, 2016. Prague. Climacteric; 2016;19(sup1):p48.
- 17. Bair MJ, Wu J, Damush TM, Sutherland JM, Kroenke K. Association of depression and anxiety alone and in combination with chronic musculoskeletal pain in primary care patients. Psychosom Med. 2008;70:890. https://doi.org/10.1097/PSY.0b013e318185c510.
- 18. Meints SM, Mawla I, Napadow V, Kong J, Gerber J, Chan ST, et al. The relationship between catastrophizing and altered pain sen - sitivity in patients with chronic low-back pain. Pain. 2019;160(4), 833–843. doi:10.1097/j.pain.0000000000001461.
- 19. Subhadra KT. Low back pain: Correlation with anxiety, depres- sion, and well-being and the effect of homeopathic medicines on the physical signs of patients. Int J Med Sci. 2017;6(9), 1427- 1432.
- 20. Comachio J, Magalhães MO, Campos Carvalho E Silva, APDM, Marques AP. A cross-sectional study of associations between kinesiophobia, pain, disability, and quality of life in patients with chronic low back pain. Adv Rheumatol. 2018;58. doi:10.1186/ s42358-018-0011-2.
- 21. Kanwaljit Chopra, Vipin Arora. An intricate relationship between pain and depression: clinical correlates, coactivation factors and therapeutic targets. Expert Opin Ther Targets. 2014;18:2, 159- 176, DOI: 10.1517/14728222.2014.855720.
- 22. Yazıcı K, Tot Ş, Biçer A, Yazıcı A, Buturak V. Anxiety, Depression and Quality of Life in Patients with Lowback Pain and Neck Pair. J Clin Psychol. 2003;6:95-101.
- 23. Casten RJ, Parmelee PA, Kleban MH, Lawton MP, Katz IR. The relationships among anxiety, depression, and pain in a geriatric institutionalized sample. Pain. 1995;61:271-276. https://doi. org/10.1016/0304-3959(94)00185-h.
- 24. Kuch K, Cox B, Evans RJ, Watson PC, Bubela C. To what extent do anxiety and depression interact with chron- ic pain? Can J Psychiatry. 1993;38:36-38. https://doi. org/10.1177/070674379303800110.
- 25. Ranger TA, Cicuttini FM, Jensen TS, Manniche C, Heritier S, Ur- quhart DM. Catastrophization, fear of movement, anxiety, and depression are associated with persistent, severe low back pain, and disability. The Spine Journal. 2020;6:857-865. https://doi. org/10.1016/j.spinee.2020.02.002.
- 26. Marshall PWM, Schabrun S, Knox MF. Physical activity and the mediating effect of fear, depression, anxiety, and catastrophizing on pain related disability in people with chronic low back pain. PLOS ONE. 2017; 12(7). doi:10.1371/journal.pone.0180788.
- 27. Dündar Ü, Özlem S, Demirdal ÜS, Toktas H, Kavuncu V. Relation of pain, disability and depression with quality of life in patients with chronic low back pain. Genel Tip Derg. 2009;19:99-104.
- 28. Erden A, Şenocak E. An analysis on factors affecting back awareness of postmenopausal women with chronic low back pain. JETR. 2020;7(1), 21-27.
- 29. Güçlü DG, Güçlü O, Ozaner A, Şenormancı O, Konkan R. The relationship between disability, quality of life and fear-avoid- ance beliefs in patients with chronic low back pain. Turk Neu- rosurg. 2012;22:724-731. https://doi.org/10.5137/1019-5149. JTN.6156-12.1.
- 30. Baillie L, Bacon CJ, Hewitt CM, Moran RW. Predictors of func- tional improvement in people with chronic low back pain follow- ing a graded Pilates-based exercise programme. J Bodyw Mov Ther. 2019;23,211–218. doi:10.1016/j.jbmt.2018.06.007.
- 31. Korkmaz N, Akinci A, Yörükan S, Sürücü HS, Saraçbaşi O, Ozça- kar L. Validation and Reliability of the Turkish Version of the Fear Avoidance Beliefs Questionnaire in Patients With Low Back Pain. Eur J Phys Rehabil M. 2009;45:527-35.
- 32. Cederbom S, Söderlund A, Denison A, Wagert PH. Chronic pain among older women living alone. A study focusing on disability and morale. Eur J Physiother. 2014;16:139-150. https://doi.org/ 10.3109/21679169.2014.893448.
- 33. Helminen EE, Sinikallio SH, Valjakka AL, Väisänen-Rouvali RH, Arokoski JPA. Determinants of pain and functioning in knee osteo- arthritis: a one-year prospective study. Clin Rehabil. 2016;30:890- 900. https://doi.org/10.1177/0269215515619660.
| APA | Erden A, TURHAN K, Albayrak M, SENOCAK E (2021). STRUCTURAL EQUATION MODELLING TO EXAMINE THE AFFECTED FACTORS OF KINESIOPHOBIA IN POSTMENOPAUSAL WOMEN WITH CHRONIC LOW BACK PAIN. , 22 - 32. 10.21653/tjpr.797833 |
| Chicago | Erden Arzu,TURHAN Kemal,Albayrak Muammer,SENOCAK EMRE STRUCTURAL EQUATION MODELLING TO EXAMINE THE AFFECTED FACTORS OF KINESIOPHOBIA IN POSTMENOPAUSAL WOMEN WITH CHRONIC LOW BACK PAIN. (2021): 22 - 32. 10.21653/tjpr.797833 |
| MLA | Erden Arzu,TURHAN Kemal,Albayrak Muammer,SENOCAK EMRE STRUCTURAL EQUATION MODELLING TO EXAMINE THE AFFECTED FACTORS OF KINESIOPHOBIA IN POSTMENOPAUSAL WOMEN WITH CHRONIC LOW BACK PAIN. , 2021, ss.22 - 32. 10.21653/tjpr.797833 |
| AMA | Erden A,TURHAN K,Albayrak M,SENOCAK E STRUCTURAL EQUATION MODELLING TO EXAMINE THE AFFECTED FACTORS OF KINESIOPHOBIA IN POSTMENOPAUSAL WOMEN WITH CHRONIC LOW BACK PAIN. . 2021; 22 - 32. 10.21653/tjpr.797833 |
| Vancouver | Erden A,TURHAN K,Albayrak M,SENOCAK E STRUCTURAL EQUATION MODELLING TO EXAMINE THE AFFECTED FACTORS OF KINESIOPHOBIA IN POSTMENOPAUSAL WOMEN WITH CHRONIC LOW BACK PAIN. . 2021; 22 - 32. 10.21653/tjpr.797833 |
| IEEE | Erden A,TURHAN K,Albayrak M,SENOCAK E "STRUCTURAL EQUATION MODELLING TO EXAMINE THE AFFECTED FACTORS OF KINESIOPHOBIA IN POSTMENOPAUSAL WOMEN WITH CHRONIC LOW BACK PAIN." , ss.22 - 32, 2021. 10.21653/tjpr.797833 |
| ISNAD | Erden, Arzu vd. "STRUCTURAL EQUATION MODELLING TO EXAMINE THE AFFECTED FACTORS OF KINESIOPHOBIA IN POSTMENOPAUSAL WOMEN WITH CHRONIC LOW BACK PAIN". (2021), 22-32. https://doi.org/10.21653/tjpr.797833 |
| APA | Erden A, TURHAN K, Albayrak M, SENOCAK E (2021). STRUCTURAL EQUATION MODELLING TO EXAMINE THE AFFECTED FACTORS OF KINESIOPHOBIA IN POSTMENOPAUSAL WOMEN WITH CHRONIC LOW BACK PAIN. Türk Fizyoterapi ve Rehabilitasyon Dergisi (Online), 32(3), 22 - 32. 10.21653/tjpr.797833 |
| Chicago | Erden Arzu,TURHAN Kemal,Albayrak Muammer,SENOCAK EMRE STRUCTURAL EQUATION MODELLING TO EXAMINE THE AFFECTED FACTORS OF KINESIOPHOBIA IN POSTMENOPAUSAL WOMEN WITH CHRONIC LOW BACK PAIN. Türk Fizyoterapi ve Rehabilitasyon Dergisi (Online) 32, no.3 (2021): 22 - 32. 10.21653/tjpr.797833 |
| MLA | Erden Arzu,TURHAN Kemal,Albayrak Muammer,SENOCAK EMRE STRUCTURAL EQUATION MODELLING TO EXAMINE THE AFFECTED FACTORS OF KINESIOPHOBIA IN POSTMENOPAUSAL WOMEN WITH CHRONIC LOW BACK PAIN. Türk Fizyoterapi ve Rehabilitasyon Dergisi (Online), vol.32, no.3, 2021, ss.22 - 32. 10.21653/tjpr.797833 |
| AMA | Erden A,TURHAN K,Albayrak M,SENOCAK E STRUCTURAL EQUATION MODELLING TO EXAMINE THE AFFECTED FACTORS OF KINESIOPHOBIA IN POSTMENOPAUSAL WOMEN WITH CHRONIC LOW BACK PAIN. Türk Fizyoterapi ve Rehabilitasyon Dergisi (Online). 2021; 32(3): 22 - 32. 10.21653/tjpr.797833 |
| Vancouver | Erden A,TURHAN K,Albayrak M,SENOCAK E STRUCTURAL EQUATION MODELLING TO EXAMINE THE AFFECTED FACTORS OF KINESIOPHOBIA IN POSTMENOPAUSAL WOMEN WITH CHRONIC LOW BACK PAIN. Türk Fizyoterapi ve Rehabilitasyon Dergisi (Online). 2021; 32(3): 22 - 32. 10.21653/tjpr.797833 |
| IEEE | Erden A,TURHAN K,Albayrak M,SENOCAK E "STRUCTURAL EQUATION MODELLING TO EXAMINE THE AFFECTED FACTORS OF KINESIOPHOBIA IN POSTMENOPAUSAL WOMEN WITH CHRONIC LOW BACK PAIN." Türk Fizyoterapi ve Rehabilitasyon Dergisi (Online), 32, ss.22 - 32, 2021. 10.21653/tjpr.797833 |
| ISNAD | Erden, Arzu vd. "STRUCTURAL EQUATION MODELLING TO EXAMINE THE AFFECTED FACTORS OF KINESIOPHOBIA IN POSTMENOPAUSAL WOMEN WITH CHRONIC LOW BACK PAIN". Türk Fizyoterapi ve Rehabilitasyon Dergisi (Online) 32/3 (2021), 22-32. https://doi.org/10.21653/tjpr.797833 |
